Objective
Since diplomates of the American Board of Pediatrics with permanent certificates will not be required to participate in the Maintenance of Certification (MOC) program, we determined the perceptions of permanent certificate holders about MOC and their degree of interest in participation.

Study Design
We conducted a 12-item mail survey of 1693 diplomates with permanent certificates. Frequency distributions were calculated for all survey items. χ2 statistics were used to explore associations between the variables.

Results
The response rate was 77.7%. Less than one-third of generalist respondents (28%, n = 122) and 13% of subspecialists (n = 63) agreed that they would be willing to participate in general pediatrics MOC (P < .0001). However, approximately half the subspecialists (48%, n = 221) agreed that they would be willing to participate in subspecialty MOC. Approximately three-fourths of generalists (79%, n = 354) and subspecialists (74%, n = 338) disagreed that MOC is necessary for keeping up-to-date in clinical pediatrics. Few respondents believed that parents understand the MOC program.

Conclusion
A wide range of attitudes and perceptions about MOC exists among holders of permanent certificates. Concerns about the importance of MOC to parents and the usefulness of MOC participation in improving quality of care will need to be addressed.